Nutritional Burden in Tuberculosis and Inter-sectoral Nutritional Management for Tuberculosis Patients in Malaysia

Mokti, Khalid; Isa, Zaleha Md; Manaf, Mohd Rizal Abdul; Hayati, Firdaus; Rahim, Syed Sharizman Syed Abd

doi:10.5336/medsci.2019-70810

Cited by 4 publications

(5 citation statements)

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“…Extended periods of isolation and treatment could lead to noncompliance, additional costs for the patient's family and health service, and stigma for the patient himself. [14] This research aimed to determine the predictors of delayed sputum smear conversion at the end of the intensive phase of anti-TB treatment of SPPTB patients in Kota Kinabalu, Malaysia. The findings of the study will contribute towards ascertaining methods to enhance sputum smear conversion as well as identifying patients who require more medical attention and care (such as advanced lung lesions) so as to improve treatment outcomes and consequently reduce time and costs which would otherwise be necessary for the third month's additional smear test.…”

Section: Introductionmentioning

confidence: 99%

“…Any incidence of delayed conversion of positive sputum smear at the end of the intensive phase of treatment presents a high risk of spreading the infection; this thus necessitates a further period of isolation for the TB patient due to the extension of treatment. Extended periods of isolation and treatment could lead to non-compliance, additional costs for the patient's family and health service, and stigma for the patient himself [14] …”

Section: Introductionmentioning

confidence: 99%

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Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia

et al. 2021

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Smear-positive pulmonary tuberculosis (SPPTB) is the major contributor to the spread of tuberculosis (TB) infection, and it creates high morbidity and mortality worldwide. The objective of this study was to determine the predictors of delayed sputum smear conversion at the end of the intensive phase of TB treatment in Kota Kinabalu, Malaysia.This retrospective study was conducted utilising data of SPPTB patients treated in 5 TB treatment centres located in Kota Kinabalu, Malaysia from 2013 to 2018. Pulmonary TB (PTB) patients included in the study were those who had at least completed the intensive phase of anti-TB treatment with sputum smear results at the end of the 2nd month of treatment. The factors associated with delayed sputum smear conversion were analyzed using multiple logistic regression analysis. Predictors of sputum smear conversion at the end of intensive phase were evaluated.A total of 2641 patients from the 2013 to 2018 periods were included in this study. One hundred eighty nine (7.2%) patients were identified as having delayed sputum smear conversion at the end of the intensive phase treatment. Factors of moderate (advanced odd ratio [aOR]: 1.7) and advanced (aOR: 2.7) chest X-ray findings at diagnosis, age range of >60 (aOR: 2.1), year of enrolment 2016 (aOR: 2.8), 2017 (aOR: 3.9), and 2018 (aOR: 2.8), smokers (aOR: 1.5), no directly observed treatment short-course (DOTS) supervisor (aOR: 6.9), non-Malaysian citizens (aOR: 1.5), and suburban home locations (aOR: 1.6) were associated with delayed sputum smear conversion at the end of the intensive phase of the treatment.To improve sputum smear conversion success rate, the early detection of PTB cases has to be fine-tuned so as to reduce late or severe case presentation during diagnosis. Efforts must also be in place to encourage PTB patients to quit smoking. The percentage of patients assigned with DOTS supervisors should be increased while at the same time ensuring that vulnerable groups such as those residing in suburban localities, the elderly and migrant TB patients are provided with proper follow-up treatment and management. Abbreviations: 95% CI = 95% confidence interval, AFB = acid fast bacilli, aOR = advanced odd ratio, DOTS = directly observed treatment short-course, EPTB = extrapulmonary tuberculosis, Mtb = Mycobacterium tuberculosis, PTB = pulmonary tuberculosis, SPPTB = smear-positive pulmonary tuberculosis, TB = tuberculosis, TBTC = tuberculosis treatment centres.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia

et al. 2021

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“…66 Theoretically, it could also lead to an upsurge in treatment costs, non-adherence and ongoing stigma. 67 …”

Section: Discussionmentioning

confidence: 99%

“…66 Theoretically, it could also lead to an upsurge in treatment costs, non-adherence and ongoing stigma. 67 The reason behind zinc and vitamin A supplementation being associated with sputum smear conversion at 2 months following treatment initiation but not with successful TB treatment outcomes merits further discussion. The included trials had a limited sample size and their primary outcome of interest was predominantly early bactericidal activity in the form of sputum conversion status 2 months following treatment initiation.…”

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confidence: 99%

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Effects of zinc and vitamin A supplementation on prognostic markers and treatment outcomes of adults with pulmonary tuberculosis: a systematic review and meta-analysis

et al. 2022

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IntroductionUndernutrition is a major risk factor for tuberculosis (TB), which is estimated to be responsible for 1.9 million TB cases per year globally. The effectiveness of micronutrient supplementation on TB treatment outcomes and its prognostic markers (sputum conversion, serum zinc, retinol and haemoglobin levels) has been poorly understood. This study aimed to determine the effect of zinc and vitamin A supplementation on prognostic markers and TB treatment outcomes among adults with sputum-positive pulmonary TB.MethodsA systematic literature search for randomised controlled trials (RCTs) was performed in PubMed, Embase and Scopus databases. Meta-analysis with a random effect model was performed to estimate risk ratio (RR) and mean difference (MD), with a 95% CI, for dichotomous and continuous outcomes, respectively.ResultsOur search identified 2195 records. Of these, nine RCTs consisting of 1375 participants were included in the final analyses. Among adults with pulmonary TB, zinc (RR: 0.94, 95% CI: 0.86 to 1.03), vitamin A (RR: 0.90, 95% CI: 0.80 to 1.01) and combined zinc and vitamin A (RR: 0.98, 95% CI: 0.89 to 1.08) supplementation were not significantly associated with TB treatment success. Combined zinc and vitamin A supplementation was significantly associated with increased sputum smear conversion at 2 months (RR: 1.16, 95% CI: 1.03 to 1.32), serum zinc levels at 2 months (MD: 0.86 μmol/L, 95% CI: 0.14 to 1.57), serum retinol levels at 2 months (MD: 0.06 μmol/L, 95% CI: 0.04 to 0.08) and 6 months (MD: 0.12 μmol/L, 95% CI: 0.10 to 0.14) and serum haemoglobin level at 6 months (MD: 0.29 μg/dL, 95% CI: 0.08 to 0.51), among adults with pulmonary TB.ConclusionsProviding zinc and vitamin A supplementation to adults with sputum-positive pulmonary TB during treatment may increase early sputum smear conversion, serum zinc, retinol and haemoglobin levels. However, the use of zinc, vitamin A or both was not associated with TB treatment success.PROSPERO registration numberCRD42021248548.

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Factor Associated with Underweight among People with Tuberculosis

Fitriyana

Ayuningrum

2021

JBE

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Background: The relationship between Tuberculosis (TB) and nutritional status is a significant one. Patients with TB who are underweight face a higher risk of death. Purpose: This research aims to analyze the factors related to the occurrence of being underweight among TB patients at the Public Health Center (PHC) in Perak Timur, Surabaya. Method: This was an analytical observational study and used a cross-sectional design. The sample for this research was 41 respondents, who were TB patients and were undergoing treatment at the PHC in Perak Timur, Surabaya. Data collection was done from March 2020 to June 2020. Primary data was collected by conducting interviews using a questionnaire. Data analysis was performed using a chi-square test. Results: The results indicated that, out of the 41 respondents, there were 21 respondents who were underweight (51.22%). Descriptively, underweight TB patients were more likely to be in the intensive phase of treatment (90%), have a low income (56.76%), have a low education status (65.38%), and be unemployed (59.38%), with PR=0.43 and 95%CI=0.76–9.38. The results of this research indicated a link between the treatment phase and TB patients being underweight (p=0.01; PR=2.33; 95% CI=1.43–3.79), the level of education attained by underweight TB patients (p=0.04; PR=0.41; 95% CI=0.17–0.99), and the income of underweight TB patients (p=0.04; PR=0.43; 95%CI=0.30–0.63). The results of this research indicated that there was a correlation between the work status and TB patients being underweight (p=0.07; PR=2.67; 95%CI=0.76–9.38). Conclusion: The treatment phase, education level and income are significantly related to TB patients being underweight.

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Nutritional Burden in Tuberculosis and Inter-sectoral Nutritional Management for Tuberculosis Patients in Malaysia

Cited by 4 publications

References 36 publications

Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia

Predictors of delayed sputum smear conversion among pulmonary tuberculosis patients in Kota Kinabalu, Malaysia

Effects of zinc and vitamin A supplementation on prognostic markers and treatment outcomes of adults with pulmonary tuberculosis: a systematic review and meta-analysis

Factor Associated with Underweight among People with Tuberculosis

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